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This approach is only appropriate for individuals who have previously tolerated GLP-1 agonists

Phentermine, in particular, carries a well-documented side effect profile that includes: Cardiovascular effects : elevated heart rate, increased blood pressure, and palpitations Central nervous system effects : insomnia, anxiety, restlessness, and dizziness Gastrointestinal symptoms : dry mouth, nausea, and constipation Dependence and withdrawal : phentermine has stimulant properties and carries a risk of psychological dependence with prolonged use Phentermine and related sympathomimetic agents are contraindicated in people with uncontrolled hypertension, ischaemic heart disease, arrhythmias, hyperthyroidism, glaucoma, or a history of drug or alcohol misuse

All the fractionation steps were performed at 4C

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